Orofacial Granulomatosis among Pediatric Patients Well Controlled by Corticosteroid Treatment: A Rare Case Series

Table 1

Clinical characteristics of four pediatric patients with orofacial granulomatosis.

Characteristics		Patient #1	Patient #2	Patient #3	Patient #4
Background	Age (years)	Seven	Seven	Nine	Seven
	Sex	F	F	M	M
	Medical histories	Allergy to household dust	Allergy to tree nuts, bronchial asthma, and constipation	ADHD	N/A
	Complaints	Recurrent upper gingival swelling and bleeding while brushing			Recurrent labial and upper gingival swelling and bleeding while brushing
	History of therapeutic intervention	Local corticosteroid treatment antimicrobial treatment with cefcapene pivoxil	Local corticosteroid treatment	Antimicrobial treatment with cefcapene pivoxil	Antimicrobial treatment with amoxicillin and antiallergic treatment with bepotastine, a selective antagonist of the histamine 1 receptor
First diagnosis		Plaque-induced gingivitis	Allergic gingivitis		Plaque-induced gingivitis and suspicion of HAE
Blood test	WBC (×10^4/μL)	9	4.4	5.7	7.3
	Platelets (×10^4/μL)	308	289	351	367
	C-reactive protein (mg/dL)	<0.02	0.22	<0.02	<0.02
	IgE (IU/mL)	N/A	1055.4	7566.9	N/A
	C1 inactivator (%)	119	N/A	N/A	N/A
	C4 (mg/dL)	22	38	27	19
	CH50 (U/mL)	55.6	60.3	52	55.7
	sIL-2R (U/mL)	372	448	374	676
	KL-6 (U/mL)	210	368	241	478
Pathological examinations		Granulomatous inflammation
Treatment strategies		Oral health care
		Local corticosteroid treatment with gargle	Systemic corticosteroid treatment
Side effects		None	Moon face, weight gain	None	Declining adrenal cortex function
Outcomes		No evidence of recurrence		Recurrence five month after the completion of corticosteroid treatment	No evidence of recurrence